Medicare, Medicaid, Life and Health Insurance/Medicare Coverage of MRIs


Hi, my sister-in-law is having problem with both of her shoulders. She got an MRI in one shoulder and the doctor determined that while arthritis is part of the problem, there are other issues that need to be addressed. He told her that she cannot get an MRI of the other shoulder because two MRIs cannot be done "at the same time." She asked if she could get an MRI of the other shoulder in January since it's a new year, but her doctor said, no, it's not about the number of MRIs in the year, but again it was about getting more than one MRI "at the same time."

That makes no sense to me and I cannot find anything to support that idea. Do you know if that's true? She has two different shoulders and just because an MRI on one shoulder is done and shows X doesn't mean that that's what's going on in the other shoulder, right?

Can you shed some light on this?

Thank you.

You can't have 2 MRIS in the same day at a free standing private imaging center because the insurante will only pay half for the 2nd one.
But if you go to a,hospital the rules are different. This is for Medicare and other countries follow the rules of Medicare.
What is,her insurance. What did the xrays,show. Need more info to help you.


Medicare, Medicaid, Life and Health Insurance

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Merry Schiff


I am very familar with Medicare and general insurance questions. I can answer general questions about HMO's.


I have been in the medical billing industry for 50 years. I have helped develop software for this industry. I am a consultant to billers and the medical profession.

I am the Executive Director of NEBA, a medical billing organization with nearly 1000 members.

I have been teaching medical billing for many years as well as being a published author with Pearson Education. One book on medical billing (nearly 800 pages) and one on HIPAA.

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